Nikisha Blue Waters Zanon, MSW is a medicare enrolled "Counselor - Mental Health" provider in Iron Mountain, Michigan. Her current practice location is
440 Woodward Ave, Iron Mountain, Michigan. You can reach out to her office (for appointments etc.) via phone at
(906) 776-9040.
Nikisha Blue Waters Zanon is licensed to practice in Michigan (license number 6801117454) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1710517883.
Healthcare Provider's Profile
Full Name | Nikisha Blue Waters Zanon |
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Gender | Female |
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Speciality | Counselor - Mental Health |
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Location | 440 Woodward Ave, Iron Mountain, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1710517883
- Provider Enumeration Date: 01/17/2020
- Last Update Date: 12/19/2023
Medicare PECOS Information:
- PECOS PAC ID: 8325486939
- Enrollment ID: I20240402001871
Medical Identifiers
Medical identifiers for Nikisha Blue Waters Zanon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1710517883 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 6801106247 (Michigan) | Secondary |
101YM0800X | Counselor - Mental Health | 6801117454 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nikisha Blue Waters Zanon allows following entities to bill medicare on her behalf.
Entity Name | Bellin Psychiatric Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1801150206 PECOS PAC ID: 4486551058 Enrollment ID: O20121222000022 |
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Entity Name | Oconto Hospital & Medical Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1356799969 PECOS PAC ID: 2163461781 Enrollment ID: O20161123001560 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nikisha Blue Waters Zanon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Nikisha Blue Waters Zanon, MSW Po Box 22040, Green Bay, WI 54305-2040 Ph: (920) 445-7222 | Nikisha Blue Waters Zanon, MSW 440 Woodward Ave, Iron Mountain, MI 49801-4631 Ph: (906) 776-9040 |
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